A retrospective study on optimal number of cycles of the first-line platinum-based chemotherapy for metastatic urothelial carcinoma

•Optimal number of cycles of platinum-based chemotherapy for mUC has not been determined.•Five or more cycles of platinum-based chemotherapy did not prolong OS compared with four cycles.•Considering the new treatment strategy with switch maintenance with avelumab, four cycles of first line chemother...

Full description

Saved in:
Bibliographic Details
Published in:Urologic oncology 2022-05, Vol.40 (5), p.194.e7-194.e14
Main Authors: Yamamoto, Shoma, Kato, Minoru, Takeyama, Yuji, Yukimatsu, Nao, Hirayama, Yukiyoshi, Otoshi, Taiyo, Yamasaki, Takeshi, Kuratsukuri, Katsuyuki, Uchida, Junji
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Avelumab
Carboplatin
Carboplatin - therapeutic use
Carcinoma, Transitional Cell - pathology
Cisplatin
Cisplatin - therapeutic use
Female
Humans
Male
Metastatic urothelial carcinoma
Middle Aged
Number of cycles
Platinum - therapeutic use
Retrospective Studies
Urinary Bladder Neoplasms - drug therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•Optimal number of cycles of platinum-based chemotherapy for mUC has not been determined.•Five or more cycles of platinum-based chemotherapy did not prolong OS compared with four cycles.•Considering the new treatment strategy with switch maintenance with avelumab, four cycles of first line chemotherapy might be sufficient. Recently, switch maintenance with avelumab has been approved for the treatment of advanced or metastatic urothelial carcinoma (UC), with no progression after four to six cycles of first-line platinum-based chemotherapy. However, the optimal number of cycles of platinum-based chemotherapy has not been determined. To analyze the clinical characteristics of patients with advanced UC who were treated with platinum-based chemotherapy and investigate the association between the number of cycles of the treatment and the patients’ overall survival. A total of 124 patients with advanced UC who were treated with first-line platinum-based chemotherapy at Osaka City University Hospital between April 2009 and January 2020 were retrospectively reviewed. Of the 124 patients, clinical information regarding overall survival was available for 115 patients. The median age was 72 years (range, 43–95 years). Only 59 patients (51.3 %) were treated with gemcitabine and cisplatin, and 52 patients (45.2 %) were treated with gemcitabine and carboplatin. The median number of cycles was three (1–8), and the percentage of patients who discontinued chemotherapy due to progressive disease was 80.3%, 64.0%, and 86.4% in those receiving one to three, four, and five or more cycles, respectively. Moreover, no difference in overall survival was observed between patients who received four cycles and those who received five or more cycles at both univariate and multivariate levels. The present study shows that five or more cycles of first-line platinum-based chemotherapy did not prolong overall survival compared with four cycles, suggesting that four cycles of chemotherapy might be sufficient, considering the new treatment strategy involving switch maintenance with avelumab.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2021.10.013